Q&A: My son tested for TB. What should I do?
My 3 year old son tested positive for TB during his regular check up. We then had my 5 year old son tested and he is positive as well! I tested negative, but my husband hasn't been tested yet. What does this mean? Both of my boys were placed on INF for 9 months and they need to take it everyday. What happened? Why? Should I be extremely concerned? Are there any precautions I need to take with regard to their present and future health? What will the medicine do?
I’m sure the news of a positive PPD test was surprising and disturbing, but here are some facts that I hope will reassure you somewhat.
There is a difference – a big difference – between Tb infection and Tb disease. The infection occurs when a drop of infectious secretions (usually from a cough) reaches the body. This exposure alone generates a positive reaction on a PPD test, which tells us that this individual has been exposed. The next step is a chest X-ray (which I’m assuming your sons had and were negative, by their medicine doses).
If there are symptoms such as fevers, cough, sweats at night, and when a chest x-ray shows that the Tb has created an infection in the lung, it is considered active disease.
Transmission of this germ is almost always person to person, through the secretions of the respiratory tract. Most children get infected in their homes (your husband does need to be tested) but Tb has also been spread in schools, buses, churches, etc. Young children, even those with active disease, rarely infect others, largely because their coughs aren’t strong enough to send germs far enough into the environment.
In the mid 90′s, it was estimated that 10 to 20 million people in the US had Tb infections. If left untreated, only 5 to 10% of them would actually develop disease. The practice, however, is not to leave anyone untreated, but to use anti-tuberculosis agents for 9 months (Again, assuming a negative chest x-ray) INH, or isoniazid, is a well-tested, remarkably safe drug in children thatis almost 100% effective in eradicating the Tb germ. We have 30 plus years of experience with this drug, and the effectiveness seems to last at least this long. After treatment, we assume the Tb has been eliminated, and do not repeat the PPD skin test, since this remains positive for a lifetime. If in the future, there are concerns about the development of Tb or a re-exposure, a chest x-ray is done instead.